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Med Surg I > Exam 3 > Flashcards

Exam 3 Flashcards

1
Q

what are the 4 main body fluids HIV is commonly spread?

A
  1. blood
  2. semen
  3. breast milk
  4. vaginal secretions
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2
Q

HIV is most often transmitted through what? (3)

A
  1. sexual contact
  2. parenteral
  3. perinatal
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3
Q

what type of sexual contact is highest risk for HIV transmission?

A

anal sex

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4
Q

re: parenteral HIV transmission, what years were the higher risk years for transmission via blood products?

A

1978-1985 (before screening of blood products)

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5
Q

what are interventions for parenteral HIV transmission?

A

HARM REDUCTION

cleaning needles, needle exchange, PreP

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6
Q

how long should babies be treated with HIV drugs after delivery (from positive pregnant person)?

A

4-6 weeks post delivery

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7
Q

increased viral load means what?

A

increased chance of transmission

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8
Q

what is best thing health care workers can do to prevent HIV transmission?

A

standard precautions + use of safety needles

+ post exposure prophylaxis within 24 hours if exposed ◡̈

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9
Q

what does the 4th generation HIV testing detect? + in how many days?

A

HIV antibodies: 21 days

HIV p24 antigen: 14 days

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10
Q

if 4th gen HIV testing is positive, what is protocol? if negative, what is protocol?

A

positive –> test for HIV strain

negative –> test with another test (NAAT)

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11
Q

re: home testing kits for HIV, what should be done?

A

results verified w/further testing

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12
Q

what is viral load measuring? + what can it track?

A

amt of HIV viral RNA in blood

tracks: infectivity + therapy effectiveness

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13
Q

ideally, how often should a patient with positive HIV diagnosis be monitoring their viral load?

A

per Messer, q 2-3 months after diagnosis

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14
Q

what would we see re: these labs with AIDS?

lymphocytes:
CD4:
viral load:

A

lymphocytes: LOW w/fully progressed AIDS

CD4: decreases over time

viral load: increases over time (ART meds can mitigate this)

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15
Q

re: HIV/AIDS, CBC + CMP can help to track development of what?

A

opportunistic infections

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16
Q

what are the 3 stages of HIV/AIDS?

A
  1. acute (flu-like; VERY contagious)
  2. chronic (asymptomatic; can transmit to others)
  3. AIDS
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17
Q

what is timeframe to see acute HIV stage after transmission?

A

2-4 weeks after transmission

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18
Q

what are the 2 AIDS-defining parameters?

A
  1. CD4 <200
    or
  2. development of opportunistic infections
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19
Q

what is normal CD4? what are the CD4 counts associated with each HIV stage?

A

normal 500-1500

  1. acute: >500
  2. chronic: 200-499
  3. AIDS: <200
  4. unknown: not enough info about CD4 or opportunistic infections
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20
Q

who should be screened for HIV?

A

13-65 yrs old (at least one test)

higher risk/repeated high risk exposures (IVDU or sex workers) –> annually/frequently

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21
Q

what is the PRIORITY assessment of positive HIV/AIDS patient?

KNOW

A

early detection + management of infections

patient education

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22
Q

what is PRIORITY nursing care for patient with HIV/AIDS?

A

handwashing!! (infection risk - keeping patient safe)

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23
Q

what is most common opportunistic infection with AIDS?

KNOW

A

Pneumocystis pneumonia (PCP)

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24
Q

how does pneumocystis pneumonia present? (name s+s)

KNOW

A

PNA:

cough, dyspnea, SHOB, crackles in lungs, fever, tachypnea

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25
Q

what is tx for pneumocystis pneumonia?

KNOW

A

antibiotics (bactrim) + support (O2 + positive pressure)

these txs can increase risk of infection even more :(

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26
Q

disseminated MAC has ONLY been seen with which 2 scenarios with AIDS patients?

KNOW

A
  1. CD4 <50
    or
  2. patients not on ART drugs
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27
Q

if patient receives PPD test and is HIV positive, what is positive result?

A

> 5mm

may not be best screening test for immunocompromised - best with NAAT, CXR or sputum

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28
Q

what do we need to KNOW about Kaposi’s sarcoma r/t AIDS?

A

that it improves with ART drugs

per Messer

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29
Q

what interventions r/t oxygenation should we implement for HIV/AIDS patients?

A

elevate HOB + O2 therapy

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30
Q

what interventions r/t nutrition should we implement for HIV/AIDS patients?

A

high calorie, high protein, low fat

small, frequent meals

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31
Q

how can we educate patients with HIV/AIDS to prevent infection? (7)

A
  1. monitor vitals + temp
  2. no fresh plants, flowers or sick visitors
  3. avoid raw foods
  4. handwashing
  5. don’t handle pet litter
  6. bathe daily
  7. don’t share personal items
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32
Q

what are the characteristics of all autoimmune disease?

A
  1. periods of exacerbation + remission
  2. chronic + progressive
  3. systemic effects: fever, fatigue, weakness, anorexia, weight loss
  4. inflammation of connective tissues
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33
Q

what is the pathophysiology of RA?

A

forms autoantibodies + rheumatoid factors that affect healthy tissues (especially likes synovial joints)

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34
Q

what can happen with RA over time if left untreated?

A

major deformities + bone fusions

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35
Q

when does RA often present?

A

winter months

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36
Q

what are the s+s of RA in early stage?

A

red, warm, tender, swollen + stiff joints - symmetrical

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37
Q

what joints are most commonly affected with RA?

A

upper extremity joints (synovial)

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38
Q

what are the s+s of RA in late stage? (5)

A
  1. inflammation in more joints
  2. gel phenomenon
  3. joint effusions
  4. spindle like fingers
  5. muscle atrophy –> dec ROM
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39
Q

TMJ with RA signifies what?

A

SEVERE disease

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40
Q

RA affecting cervical joints puts a person at risk for what?

A

paralysis

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41
Q

aside from the “usual” systemic effects of RA, what other things can you see? (3)

A
  1. subcutaneous nodules (forearms)
  2. vasculitis
  3. paresthesia –> foot drop

“Very Painful Shit”

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42
Q

re: RA, what is vasculitis? what does it present as? what is person at risk for?

A

what: inflammation of vessels
presentation: periungual lesions on fingers

@ risk for: organ ischemia (kidneys + lungs most worrisome)

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43
Q

what are Baker’s cysts and which condition are they associated with?

A

enlarged popliteal bursae; associated with RA

tx of underlying disease is best for these

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44
Q

what is sjorgen’s syndrome?

A

attacking glands that lubricate; often with another autoimmune disease

eyes, mouth, vagina

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45
Q

re: RA, what should we be examining with these patients in regard to quality of life?

A

how are their ADLs impacted? are their medications working and helping them to achieve their ADLs? <3

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46
Q

diagnosis for RA

A

no definitive; only supportive; very difficult

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47
Q

if an arthrocentesis was performed on a person with suspected RA, what findings would you expect to see?

A

fluid cloudy w/WBCs

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48
Q

what is our priority intervention for person wtih RA?

A

rest, balance + setting priorities

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49
Q

if patient with RA was too tired to take a bath and wanted to skip it, what would be your best response?

A

teaching them why hygiene is so important, especially with immunosuppressive medications + offering a bed bath with CHG wipes

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50
Q

describe the differences between RA + Osteoarthritis

A

RA: autoimmune, symmetrical, worse after resting

OA: wear and tear/degenerative, generalized, worse after activity

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51
Q

pathophysiology of SLE

A

production of antinuclear antibodies + immune complexes

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52
Q

re: SLE, the immune complexes have an affinity for which organ?

A

kidneys

can impact the organs directly or the vessels that perfuse them

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53
Q

SLE is most common in which population

A

females of color

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54
Q

what is the unique sign of SLE?

A

“butterfly rash”

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55
Q

function of which organ is VERY IMPORTANT with SLE?

A

kidneys - because the immune complexes are nephrophilic + cause systemic inflammation

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56
Q

this condition is triggered by stress or cold and NOT exclusive to Lupus

A

Reynaud’s Phenomenon

extreme pallor or red/blue of fingers –> can lead to loss of digits

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57
Q

what is our priority nursing education for patient with SLE?

A

avoid direct sunlight + wear sunscreen (skin protection)

+ derm referral is also important

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58
Q

what symptom do we educate patients with SLE to monitor for to recognize impending exacerbations?

A

low grade fever

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59
Q

what is systemic sclerosis?

A

autoimmune disorder causing hardening of skin + eventually inflammation of connective tissue

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60
Q

what is leading cause of death with systemic sclerosis?

A

kidney sclerosis (systemic inflammation)

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61
Q

limited cutaneous systemic sclerosis is associated with which syndrome? describe it.

A

CREST

Calcium deposits in skin
Raynaud's phenomenon
Esophageal Dysfunction
Sclerodactyly (tightened skin on fingers/toes)
Telangiectasis (spider capillaries)
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62
Q

s+s of systemic sclerosis (6)

A
  1. painful + stiff joints
  2. pitting edema
  3. shiny skin (b/c of hardening)
  4. taut skin
  5. joint contractures
  6. loss of ROM
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63
Q

re: systemic sclerosis, describe the organ involvement (GI, lungs, CV, kidney)

A

digestive tract –> dysphagia
CV –> raynaud’s
lungs –> pulmonary HTN
kidneys –> DEATH

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64
Q

what is #1 cause of death with systemic sclerosis?

A

kidney failure

based on googling, this is not accurate, but according to messer, kidneys are the cause

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65
Q

re: systemic sclerosis and involvement of digestive tract, what would be your priority intervention?

A

ability to swallow safely (r/t dysphagia)

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66
Q

what are 3 interventions for patient with scleroderma?

A
  1. bed cradle (avoid skin breakdown + pain)
  2. foot board (prevent contractures)
  3. keep room warm (prevent raynaud’s)
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67
Q

what is gout?

A

systemic arthritis r/t uric acid build up

NOT autoimmune

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68
Q

what is a very common cause for secondary gout?

A

kidney disease (hyperuricemia b/c of impaired excretion)

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69
Q

with acute gout attack, where is the pain often manifested?

A

big toe (excruciating!!)

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70
Q

what happens with chronic/tophaceous gout?

A

urate crystals deposit in major organs

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71
Q

re: gout, urate crystals have an affinity to which organs?

A

kidneys (nephrophilic)

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72
Q

s+s of gout

A

joint inflammation + severe pain

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73
Q

interventions for gout (2) + what things should be avoided?

A
  1. fluids
  2. low purine diet
  3. avoid ASA, diuretics, stress
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74
Q

what foods should people avoid with gout? give examples

KNOW

A

purine-containing foods

avoid organ meat, shellfish, oily fish w/bones

(egg would be good protein choice)

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75
Q

main interventions for patients with sensory problems

A

know how to optimize communication + keep patient safe (per Messer) **

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76
Q

what is our priority assessment and intervention for patients with sensory deficits?

A

communication + anxiety (per Messer) + keeping them safe

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77
Q

what is cataracts?

A

lens opacity + cloudiness

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78
Q

what are the 2 major risk factors for cataracts?

KNOW

A

aging (>70) + sun exposure (not wearing sunglasses)

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79
Q

what would you see re: vision with person with cataracts?

A

blurred vision + decreased color perception

–> leads to double vision

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80
Q

what is priority intervention for cataracts?

A

sunglasses + hats (sun protection)

81
Q

after cataract surgery, when will you see vision improvement?

A

improves 1st day after surgery –> max 4-6 weeks after

82
Q

after cataract surgery, what should be reported? (3)

A
  1. s+s of increased ICP (ex: pain, N/V)
  2. infection
  3. bleeding
83
Q

what restrictions should be in place for patients following cataract surgery?

A

activity restrictions - avoid anything that could increase ICP

84
Q

what is the patho of glaucoma?

A

increased pressure in eye –> pressure on nerves –> nerve death –> blindness

85
Q

can glaucoma be prevented?

A

NO, but we can treat it to prevent blindness

86
Q

glaucoma is associated with a gradual loss of what (r/t vision)?

A

peripheral vision

87
Q

what is best way to detect glaucoma?

+ what is normal tonometry measure?

A

YEARLY eye exams (tonometry: “the lil puff of air; normal 10-21 mmHg)

88
Q

what is most common type of glaucoma?

KNOW

A

Primary open angle glaucoma

89
Q

s+s of primary open angle glaucoma (3)

KNOW

A
  1. foggy vision
  2. halos
  3. SLOW loss of peripheral vision w/no improvement with glasses

“angels (angles) try to see in the fog by putting on their glasses but don’t have peripheral vision”

90
Q

what is primary angle closure glaucoma? what are s+s? (4)

A

ACUTE/ sudden onset EMERGENCY!!!

  1. severe eye pain –> radiates through face
  2. red sclera
  3. foggy cornea
  4. dilated + non-reactive pupil
91
Q

how is glaucoma managed? + what is nursing role?

KNOW

A

with eyedrops

nursing role: proper eye drop admin education - wash hands, conjunctival sac, punctal occlusion to avoid systemic admin

92
Q

what is macular degeneration?

A

deterioration of central vision

93
Q

what is most common form of macular degeneration? what is patho

A

dry

retina capillaries are blocked –> ischemia –> necrosis –> complete vision loss

94
Q

what are risk factors for macular degeneration?

A
  1. smoking
  2. HTN
  3. diet low in carotene + vit E

interventions are aimed at all of these

95
Q

what are some nursing interventions for macular degeneration?

A

KEEP THEM SAFE

call bell close, items within reach, keep environment clutter-free, promote safe independence

96
Q

what is retinal detachment?

A

separation of retina from epithelium

97
Q

what are s+s of retinal detachment? (3) + what is onset? + what is pain level?

A

SUDDEN, painless

  1. flashes of light
  2. “floaters”
  3. sudden loss of portion of vision
98
Q

what are post op nursing interventions for retinal detachment surgery?

A
  1. avoid fine eye movements (reading)
  2. monitor for infection
  3. wear eye patch
  4. educate patients about risk of repeated detachment
99
Q

what is a great intervention for prevention of hearing loss r/t noise pollution?

A

wearing earphones to protect ears / hearing

100
Q

hearing loss interventions are aimed at what? (3)

A
  1. the cause
  2. stopping progression
  3. restoring hearing
101
Q

what should we educate patients on re: hearing aids and first time using them?

KNOW

A

when first getting used to them, everything will be louder, even background noise –> ease into wearing them, go for short periods of time at first and build up, avoid large crowds with lots of noise at first

102
Q

what is osteoarthritis?

A

wearing down of cartilage in the joints –> leads to bone on bone –> PAINFUL

(“wear and tear” disease/degenerative)

103
Q

where is osteoarthritis most commonly found?

A

hips, knees, spine, hands

104
Q

what are bone spurs + where are they commonly found?

A

hard bumps of extra bone from osteoblastic activity

commonly in HEELS

105
Q

what are the 2 primary causes of osteoarthritis?

A

aging + genetics

106
Q

what would we see regarding activity + rest with osteoarthritis?

A

worse after activity + better after rest

107
Q

what are the 2 distinct signs you may see with osteoarthritis?

A

bouchard’s nodes (proximal fingers) + heberden’s nodes (distal fingers)

108
Q

what is our primary intervention for osteoarthritis?

A

pain management: tylenol first + then NSAIDs if person can take them

109
Q

aside from meds, what are some other interventions for osteoarthritis?

A
  1. lidoderm patches
  2. hot or cold therapy (focus on heat)
  3. balancing exercise + rest
  4. non high impact exercise: swimming, walking, cycling, aerobics
110
Q

can osteoarthritis be cured?

A

no - teach patients to be aware of curative remedies! many out there!

111
Q

what is a total joint arthroplasty? when is it indicated?

A

surgical creation of a joint; indicated when quality of life cannot be maintained anymore

112
Q

what are 2 most common locations for total joint arthroplasty?

A

knees + hips

113
Q

what are the 5 contraindications for total joint arthroplasty?

A
  1. infection
  2. advanced osteoporosis
  3. severe inflammation
  4. severe DM
  5. on dialysis
114
Q

what is MAIN focus of preoperative care for joint arthroplasty patients?

A

EDUCATION! set patient up for success before surgery + for when they will return home (do they have everything they need??)

115
Q

what is important re: dental work after joint replacements?

A

patients should inform provider before surgery - antibiotic therapy to prevent infection

116
Q

what are the two options for hip joint arthroplasty? how is it determined?

A

press fitted or cemented

(cemented deteriorates more quickly, so usually chosen for older adults, whereas press fit are good for longer periods of time, so often used with younger persons)

117
Q

describe difference between press fitted or cemented hip joint arthroplasty

KNOW

A

press fitted: cannot immediately bear weight; osteoblasts need to build around this before stable; lasts longer

cemented: can bear weight immediately; deteriorates quickly

118
Q

s+s of dislocation post op for total hip joint arthroplasty; what should be done?

A
  1. severe pain
  2. shortening or rotation of leg

immediately call surgeon!

119
Q

people are at a very high risk of what post knee or hip surgery?

A

DVT + PE

monitor for s+s of both

120
Q

to monitor for neurovascular compromise post joint arthroplasty, what should we assess?

A

CMS: circulation, motion, sensation

is there a pulse? can they move it? can they feel it?

121
Q

what are 3 precautions to take post hip joint arthroplasty?

A
  1. knees at 90* angle
  2. don’t cross legs
  3. use abduction pillow (great for a confused older adult to prevent dislocation)
122
Q

what positioning should be maintained post knee replacement surgery?

A

neutral position (avoid hyperextension + rotation)

123
Q

if there’s a posterior approach for a total hip replacement, do you need an abduction pillow?

A

yes!

Random fact that Messer said to KNOW at the end of the lecture?

124
Q

with any type of approach for total hip replacement, what are you worried about?

A

rotation

random fact that Messer said to KNOW at the end of the lecture?

125
Q

what is osteoporosis?

A

chronic bone loss –> decreased density + increased fracture

(osteoclast activity > osteoblast activity = thin, fragile bones)
:(

126
Q

what areas of the body are at highest risk of fracture from osteoporosis?

A

spine, hip + wrist

127
Q

what hormone is very important to maintain bone density?

A

estrogen

when this drops w/menopause, someone is at high risk of developing osteoporosis

128
Q

what are some risk factors for osteoporosis?

A
  • female
  • thin body build
  • diet low in Vit D + calcium
  • smoking
  • estrogen deficiency
  • excessive ETOH
  • immobility
  • medications STEROIDS - KNOW
129
Q

what exercise should we be instructing people to do to mitigate osteoporosis development?

A

weight bearing exercise (pretty much anything but swimming)

130
Q

what is the screening + diagnostic tool most often used for osteoporosis? what population should get this?

A

DXA scan; females >65 yrs old

131
Q

re: DXA scan, what T score would indicate osteoporosis?

A

-2.5 or lower

132
Q

re: DXA scan, what T score would indicate osteopenia?

A

-2.5 to -1.0

133
Q

how often is bone mineral density testing recommended?

A

q 2 yrs for people > or = 65 yrs or w/risk factors!

134
Q

in what other scenarios would bone mineral density testing be recommended?

A
  • low estrogen
  • long term steroid tx
  • hyperparathyroidism
135
Q

what is the main potential problem associated with osteoporosis?

KNOW

A

FRACTURES

136
Q

name some interventions for osteoporosis

A
  1. weight bearing exercise
  2. vit D + calcium supps
  3. strengthening exercise
  4. drug therapy
137
Q

re: osteoporosis + drug therapy, which T score would indicate a need for drug therapy?

A

T score < -2.0 with no risk factors
or
< -1.5 w/risk factors

138
Q

what is osteomyelitis? & what does it lead to?

A

infection of body tissue (caused by bacteria, fungi or virus) –> inflammation –> bone necrosis

eventually becomes a chronic pathology

139
Q

osteomyelitis results in what?

A

sequestrum (walled off area) + necrosis of bone

140
Q

what is exogenous + endogenous osteomyelitis?

A

exo: infection originates outside body
endogenous: carried from another part of the body

141
Q

what’s an example of an exogenous cause of osteomyelitis?

A

open fracture

142
Q

which infection is highly related to osteomyelitis?

A

salmonella

143
Q

what are the s+s of osteomyelitis?

A
  1. bone pain (constant, localized, pulsating) worst with movement
  2. fever > 101
  3. redness, swelling, tenderness, heat
144
Q

what is intervention for osteomyelitis?

A

long term antimicrobial therapy via PICC line

145
Q

what is a complete fracture?

A

bone broken into 2 pieces (often needs more invasive interventions)

146
Q

what is incomplete fracture?

A

bone not broken into 2 pieces / still connected

147
Q

what is open fracture? what is this type associated with?

A

bone sticking out of skin high risk of infection

148
Q

what is closed fracture?

A

bone not sticking out of skin

149
Q

greenstick fractures are often seen with which population?

A

kiddos (hard to break)

150
Q

oblique fracture

A

runs up the bone

151
Q

spiral fracture

A

runs around the bone (often from twisting)

152
Q

re: age, what bones are most commonly affected by fractures?

A

young + middle aged: femoral (long bone area)
adults: ribs
older adults: femur (near “head” + can be any part)

153
Q

what should be your priority assessment with fracture?

A

if it’s a trauma, think ABCs!!

otherwise - pain + CMS

154
Q

if person presents to ED with pain and you suspect a fracture, what would priority be?

A

GET IMAGING

155
Q

what s+s might you see with a fracture?

A
  1. pain (sometimes only symptom)
  2. change in alignment
  3. shortening of limb
  4. change in shape
  5. bruising
  6. swelling
156
Q

what is priority assessment + finding with fractures?

A

CMS! (circulation, motion, sensation) anything different than usual

157
Q

re: CMS assessment with a fracture, what is a sign of possible neurovascular compromise?

A

tingling + numbness (inflammation causing pressure on the surrounding nerves)

158
Q

what can neurovascular compromise lead to?

A

compartment syndrome –> loss of limb or death !!

159
Q

how do we diagnose fractures?

A

xray!

might also look at H+H with trauma b/c worried about bleeding

160
Q

Patient presents to ED with multiple fractures complaining of excruciating pain. what would your priority nursing diagnosis be?
A. Pain
B. Potential for Infection
C. Potential for impaired circulation/ NV compromise
D. Immobility

A

C

neurovascular compromise can lead to compartment syndrome!

161
Q

what is priority intervention for fractures?

A

if trauma, think ABC

if airway and breathing are OK, think circulation – fractures can cause swelling

162
Q

how would we reduce risk of further injury with a fracture?

A

immobilize with a splint

163
Q

what is your role as a nurse with closed reduction procedure for fracture?

A

support provider + patient by administering meds + monitoring patient

164
Q

what is most common method to manage a simple fracture?

A

closed reduction (by advanced provider)

165
Q

what type of immobilizer is preferred for fracture? why?

A

splints, b/c they can be adjusted

166
Q

re: fractures, which body parts are splints most commonly used for?

A

body parts that don’t bear weight

167
Q

re: fractures, which type of immobilizer can lead to compartment syndrome

A

casts

168
Q

what type of fractures are casts usually reserved for?

A

complex fractures + LE fractures

169
Q

what is the most commonly used material for casts? why?

A

fiberglass

dries quickly, reduces skin breakdown, can get wet

170
Q

can fiberglass casts be fully immersed in water?

KNOW

A

NO

171
Q

re: fractures, what is traction?

A

application of pulling force w/pulleys + weights

172
Q

re: traction, what should you do if you see the weights on the floor?

A

CALL PROVIDER

173
Q

what is balanced traction?

A

fractured extremity is suspended w/2 opposing forces

YOU CAN MOVE

174
Q

what is running traction? can they move extremity?

A

fractured limb is opposing force; force is w/one plane only

CANNOT MOVE EXTREMITY - will change the traction being applied

175
Q

what is one of the major differences between skin/skeletal traction vs running/balanced?

A

with skin + skeletal: bandage or anchored into skeletal system

running: one direction

ONLY balanced: person CAN MOVE extremity

176
Q

what is skin traction?

A

force applied to fractured limb with bandage or splint

177
Q

what is skeletal traction?

A

force is applied to fractured limb with pins inserted into the bone

178
Q

what is Buck’s traction? what is it used for?

A

running (one direction) + skin traction (with bandages)

used for pain reduction often with HIP

179
Q

what is one of the most common ways to reduce and fix a complex fracture?

A

open reduction w/internal fixation (ORIF)

180
Q

with ORIF surgery, what devices are used?

A

metal pins, rods, prostheses

181
Q

with ORIF surgery, what are you able to do immediately after?

A

MOBILITY! ◡̈

182
Q

hi!

A

you’ve made it halfway through this semester. you GOT THIs ◡̈

183
Q

hello future nurse

A

you will do great! keep up the hard work ◡̈

184
Q

what is the most concerning complication from a fracture?

A

acute compartment syndrome

185
Q

what is acute compartment syndrome?

A

when muscle swells within a compartment –> alteration in CMS (circulation, movement, sensation)

186
Q

how can we detect and monitor for acute compartment syndrome?

A

frequent CMS assessments

187
Q

what are the s+s of acute compartment syndrome?

A

6 P’s

pain, poikilotherma, paralysis, paresthesia, pallor, pulselessness

–> can lead to loss of limb!

188
Q

what is fat embolism syndrome (FES)?

A

fat globules released with long bone fractures (also arthroplasty surgery)

189
Q

what does FES present like?

broad, not specific symptoms

A

kinda like a PE

190
Q

when does FES (Fat Embolism Syndrome) commonly occur after trauma?

A

24-72 hrs

191
Q

what are s+s of FES?

hint: think of the 3 main body systems affected

A

think - lungs, brain, skin

lungs: low O2, dyspnea, tachypnea, SHOB
brain: confusion, HA, seizure, altered LOC
skin: petechiae

192
Q

with FES, what interventions can we do for people?

A

prevention: early fixation

  • support*
  • raise HOB + O2 therapy
  • fluids
  • albumin (binds to fatty acids)
193
Q

what 2 things define a surgical site infection? (time line)

A

if surgical site becomes infected within 30 days of surgery

OR

hardware becomes infected in the 1st year

194
Q

what is most common injury in older adults?

A

hip fracture

195
Q

hip fractures are associated with what outcome?

A

high mortality rate; r/t immobility –> myriad of problems

196
Q

what is biggest risk factor for hip fracture?

A

osteoporosis

197
Q

what medication should we avoid with managing hip fractures? why?

A

demerol (this can worsen delirium + outcomes)

198
Q

what is your priority assessment and intervention with a chest fracture?

A

think ABC - breathing problem!

Med Surg I (6 decks)

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